Uta Frith

Does the autistic child have a “theory of mind” ?

Abstract We use a new model of metarepresentational development to predict a cognitive deficit which could explain a crucial component of the social impairment in childhood autism. One of the manifestations of a basic metarepresentational capacity is a ‘theory of mind’. We have reason to believe that autistic children lack such a ‘theory’. If this were so, then they would be unable to impute beliefs to others and to predict their behaviour. This hypothesis was tested using Wimmer and Perners puppet play paradigm. Normal children and those with Downs syndrome were used as controls for a group of autistic children. Even though the mental age of the autistic children was higher than that of the controls, they alone failed to impute beliefs to others. Thus the dysfunction we have postulated and demonstrated is independent of mental retardation and specific to autism.

The Neural Basis of Mentalizing

Mentalizing refers to our ability to read the mental states of other agents and engages many neural processes. The brains mirror system allows us to share the emotions of others. Through perspective taking, we can infer what a person currently believes about the world given their point of view. Finally, the human brain has the unique ability to represent the mental states of the self and the other and the relationship between these mental states, making possible the communication of ideas.

Autism: beyond “theory of mind”

The theory of mind account of autism has been remarkably successful in making specific predictions about the impairments in socialization, imagination and communication shown by people with autism. It cannot, however, explain either the non-triad features of autism, or earlier experimental findings of abnormal assets and deficits on non-social tasks. These unexplained aspects of autism, and the existence of autistic individuals who consistently pass false belief tasks, suggest that it may be necessary to postulate an additional cognitive abnormality. One possible abnormality-weak central coherence--is discussed, and preliminary evidence for this theory is presented.

Exploration of the autistic child's theory of mind: knowledge, Belief, and communication

26 autistic children with mental ages of 3-13 years were tested on 3 tasks that are within the capability of 3- or 4-year-old normal children. The first task tested understanding of a mistaken belief. Children were shown a typical box of a certain brand of sweets, and they all thought that it contained that kind of sweet. To their surprise, however, the box contained something else. Yet, only 4 out of the 26 autistic children were able to anticipate that another child in the same situation would make the same mistake. In contrast, all but 1 of 12 children with specific language impairment, matched for mental age, understood that others would be as misled as they had been themselves. The autistic children were also tested for their ability to infer knowledge about the content of a container from having or not having looked inside. All 4 children who had passed the belief task and an additional 4 performed perfectly, but most failed. The third task assessed childrens pragmatic ability to adjust their answers to provide new rather than repeat old information. Here, too, most autistic children seemed unable to reliably make the correct adjustment. These results confirm the hypothesis that autistic children have profound difficulty in taking account of mental states.

'Theory of mind' in the brain. Evidence from a PET scan study of Asperger syndrome.

THE ability to attribute mental states to others (‘theory of mind’) pervades normal social interaction and is impaired in autistic individuals. In a previous positron emission tomography scan study of normal volunteers, performing a ‘theory of mind’ task was associated with activity in left medial prefrontal cortex. We used the same paradigm in five patients with Asperger syndrome, a mild variant of autism with normal intellectual functioning. No task-related activity was found in this region, but normal activity was observed in immediately adjacent areas. This result suggests that a highly circumscribed region of left medial prefrontal cortex is a crucial component of the brain system that underlies the normal understanding of other minds.

Vagaries of Visual Perception in Autism

Three classes of perceptual phenomena have repeatedly been associated with autism spectrum disorder (ASD): superior processing of fine detail (local structure), either inferior processing of overall/global structure or an ability to ignore disruptive global/contextual information, and impaired motion perception. This review evaluates the quality of the evidence bearing on these three phenomena. We argue that while superior local processing has been robustly demonstrated, conclusions about global processing cannot be definitively drawn from the experiments to date, which have generally not precluded observers using more local cues. Perception of moving stimuli is impaired in ASD, but explanations in terms of magnocellular/dorsal deficits do not appear to be sufficient. We suggest that abnormalities in the superior temporal sulcus (STS) may provide a neural basis for the range of motion-processing deficits observed in ASD, including biological motion perception. Such an explanation may also provide a link between perceptual abnormalities and specific deficits in social cognition associated with autism.

The impact of orthographic consistency on dyslexia: A German-English comparison

We examined reading and phonological processing abilities in English and German dyslexic children, each compared with two control groups matched for reading level (8 years) and age (10-12 years). We hypothesised that the same underlying phonological processing deficit would exist in both language groups, but that there would be differences in the severity of written language impairments, due to differences in orthographic consistency. We also hypothesized that systematic differences due to orthographic consistency should be found equally for normal and dyslexic readers. All cross-language comparisons were based on a set of stimuli matched for meaning, pronunciation and spelling. The results supported both hypotheses: On a task challenging phonological processing skills (spoonerisms) both English and German dyslexics were significantly impaired compared to their age and reading age controls. However, there were extremely large differences in reading performance when English and German dyslexic children were compared. The evidence for systematic differences in reading performance due to differences in orthographic consistency was similar for normal and for dyslexic children, with English showing marked adverse effect on acquisition of reading skills.

The cognitive basis of a biological disorder: autism

This article summarizes recent evidence indicating that individuals suffering from autism have a specific problem in understanding intentions and beliefs. We propose that this problem arises because they are incapable of forming a special kind of mental representation. A single cognitive deficit defines what is common to all autistic individuals. In contrast there is a wide range of proposals for the biological origins of the disorder.

Mind Blindness and the Brain in Autism

Experimental evidence shows that the inability to attribute mental states, such as desires and beliefs, to self and others (mentalizing) explains the social and communication impairments of individuals with autism. Brain imaging studies in normal volunteers highlight a circumscribed network that is active during mentalizing and links medial prefrontal regions with posterior superior temporal sulcus and temporal poles. The brain abnormality that results in mentalizing failure in autism may involve weak connections between components of this system.

The neuroanatomy of autism: a voxel-based whole brain analysis of structural scans.

Autism is a biological disorder which affects social cognition, and understanding brain abnormalities of the former will elucidate the brain basis of the latter. We report structural MRI data on 15 high-functioning individuals with autistic disorder. A voxel-based whole brain analysis identified grey matter differences in an amygdala centered system relative to 15 age- and IQ-matched controls. Decreases of grey matter were found in anterior parts of this system (right paracingulate sulcus, left inferior frontal gyrus). Increases were found in posterior parts (amygdala/peri-amygdaloid cortex, middle temporal gyrus, inferior temporal gyrus), and in regions of the cerebellum. These structures are implicated in social cognition by animal, imaging and histopathological studies. This study therefore provides converging evidence of the physiological basis of social cognition.